Recently, the number of cases of varicose veins in the lower extremities has been increasing in Korea, with women making up more than half of the patients. Left untreated, it can lead to complications such as swelling, pigmentation, skin ulcers, and others requiring attention.
Professor Lee Sang Ah of the Department of Vascular Surgery at Soon Chun Hyang University Bucheon Hospital said on the 23rd, “In 2020, about 145,000 female patients received treatment for varicose veins, accounting for more than half of the total. Those in their fifties were most commonly treated for varicose veins. Factors such as gender, obesity, family history, age, pregnancy, and jobs or lifestyle habits that involve standing for long periods can cause venous insufficiency, leading to varicose veins.”
Varicose veins are a condition where the veins that carry blood from the legs to the heart become bulged and dilated more than 3 mm (0.12 inches), causing problems with blood returning from the extremities to the heart. The main symptoms include heaviness in the legs, fatigue, swelling, itching, cramps, restlessness, a burning sensation, and pain when standing for a long time.
Patients can be diagnosed through a physical examination and medical history if they suspect varicose veins. As symptoms are usually more prominent when standing, it is advisable to examine a standing position.
Ultrasound tests are performed to check for venous reflux, one of the causes of venous insufficiency. The ultrasound test is essential to identify the exact location of the refluxing vein, verify the patient’s previous treatment history, and check for deep vein thrombosis.
This test induces reflux by squeezing the leg while standing or performing the Valsalva maneuver, which involves holding the breath after a deep breath and then exhaling forcefully while blocking the nose and mouth. If the reflux in the superficial veins under the skin lasts more than 0.5 seconds, or if the reflux in the deep veins lasts more than 1 second, the venous reflux is considered significant.
“If there are findings such as pain, ulcers, and pigmentation in the legs, it is important to differentiate whether they are due to rheumatic diseases, arterial diseases, or neurological problems,” said Professor Lee.
He added, “Surgery is not always necessary to treat varicose veins. If the symptoms are not severe or do not significantly interfere with daily life, non-surgical methods can be used.”
Non-surgical treatments for varicose veins include improving lifestyle habits, medication, and compression therapy. Avoiding standing or sitting for long periods and wearing compression stockings to enhance venous circulation can help improve symptoms. The length of the stockings does not significantly affect symptom improvement, so knee-length stockings are recommended due to their ease of wear and fewer skin reactions. Medications that enhance blood circulation can also help improve symptoms and relieve swelling.
The professor noted, “After some procedures like adhesive closure, compression therapy may not be necessary, but in most cases, wearing compression stockings for a certain period after surgery is recommended. The requirement and duration of wearing depend on the type of surgery. It is recommended to continuously wear the stockings during waking hours, except when sleeping, and to replace them every six months.”
